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Nurses’ reported burnout and its relationship to patients’ length of stay in Magnet hospitals 磁石医院护士倦怠报告及其与病人住院时间的关系
Pub Date : 2023-10-01 DOI: 10.24283/hjns.202241
Konstantinos Konstantidis Konstantidis, Korina Katsaliaki
Background: The health system nationally and internationally, due to the recent advent of the Covid-19 pandemic, has faced a multitude of difficulties in its functioning. The pandemic posed a serious threat to human health, causing rapid changes to the health systems and the health professionals, such as nursing staff, who were called upon to make every effort to respond to the difficulties by working intensively long hours. In these unprecedented circumstances, staff burnout has swelled and may pose a threat to patient safety. Purpose: The purpose of this study is to investigate the role of nurses’ burnout and workload in predicting covid-19 patients’ length of stay. Method: A total of 160 nurses of a General Hospital participated in the survey and 160 records were kept of 22 patients in the Intensive Care Unit (ICU) Covid-19. The Maslach questionnaire (Maslach Burnout Inventory (MBI)) was used as a study tool to measure burnout, the Nursing Activity Score (NAS) for nursing workload and the duration of hospitalization for Covid-19 patients were taken from hospital records. Multiple regression analysis was performed with the stepwise selection method, in order to be able to determine the factors that affect the patients’ length of stay. Results: Nurses’ burnout in ICU Covid-19 was found to be high as well as their workload. However, only the nursing workload (β =, 452 t = 2,124, p = 0,35) was associated with a longer patients’ length of stay in the ICU (F (1,158) = 4,512, p <, 001) and not the dimensions of burnout. Conclusions: The current pandemic pointed out the existing gaps in the health system. Nurses are unable to influence the uncontrollable course of Covid-19 disease, which has hampered their daily work and mental health and their workload has an impact on patient safety.
背景:由于最近出现的Covid-19大流行,国家和国际卫生系统在运作方面面临诸多困难。这一流行病对人类健康构成严重威胁,使保健系统和护理人员等保健专业人员迅速发生变化,这些人员被要求通过长时间高强度工作,尽一切努力应对这些困难。在这些前所未有的情况下,工作人员的倦怠加剧,并可能对患者安全构成威胁。目的:本研究的目的是探讨护士职业倦怠和工作量在预测covid-19患者住院时间中的作用。方法:某综合医院160名护士参与调查,保存重症监护病房(ICU) 22例新冠肺炎患者的160份病历。采用马斯拉赫倦怠量表(Maslach Burnout Inventory, MBI)作为研究工具测量倦怠,从医院记录中获取护理工作量和Covid-19患者住院时间的护理活动评分(NAS)。采用逐步选择法进行多元回归分析,以确定影响患者住院时间的因素。结果:新型冠状病毒肺炎重症监护病房护士的倦怠程度和工作量均较高。然而,只有护理工作量(β =, 452 t = 2,124, p = 0,35)与患者在ICU的住院时间延长有关(F (1,158) = 4,512, p <, 001),而与倦怠维度无关。结论:当前的大流行指出了卫生系统中存在的差距。护士无法对无法控制的疫情进程施加影响,这不仅影响了护士的日常工作和心理健康,而且护士的工作量也影响了患者的安全。
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引用次数: 0
The health professionals and SARS-Cov-2 pandemic. Occupational performance and mental health 卫生专业人员与SARS-Cov-2大流行职业表现与心理健康
Pub Date : 2023-04-01 DOI: 10.24283/hjns.202321
Aikaterini Stauropoulou, Konstantinia Karathanasi
Introduction: World Health Organization has designated 2021 as the International Year of Health Care Workers, recognizing the impact of the pandemic on their mental and physical health. Purpose: Investigating the impact of Covid-19 pandemic on mental health and professional performance of Greek National Health System health professionals. Material and Method: Online non-experimental quantitative cross-sectional study of 203 health care workers with a questionnaire that included a) the Health Worker’s Perception Survey on Covid-19 b) the Fear of Covid-19 questionnaire and c) the e-health questionnaire. Statistical analysis was carried out by SPSS – version 25, parametric t-test and one-way ANOVA tests were used while the level of statistical significance was set at 0.05. Results: Continuous information and the provision of Personal Protective Equipment had significant role in the performance of health professionals. The results did not show high levels of stress (M.T.=1.40) and fear (M.T.=1.14). Women presented higher levels of stress and fear compared to men (p =0.001), while health professionals who deal exclusively with the care of Covid-19 patients, had higher levels of stress (p=0.039). Also, respondents with ≥10 years of work showed greater levels of fear (p=0.014) and stress (p=0.044) than those with ≤10 years. Conclusions: Information, availability of Personal Protective Equipment and the observance of protection measures, are some important factors that during pandemic, have a decisive effect on health care workers’ efficiency and levels of fear and stress.
导言:世界卫生组织认识到疫情对医护人员身心健康的影响,已将2021年定为国际医护人员年。目的:调查2019冠状病毒病大流行对希腊国家卫生系统卫生专业人员心理健康和专业表现的影响。材料和方法:对203名卫生保健工作者进行在线非实验定量横断面研究,调查问卷包括a)卫生工作者对Covid-19的感知调查b)对Covid-19的恐惧问卷和c)电子卫生问卷。统计学分析采用SPSS - version 25,采用参数t检验和单因素方差分析,统计学显著性水平为0.05。结果:持续的信息和个人防护装备的提供对卫生专业人员的工作表现有重要作用。结果没有显示出高水平的压力(M.T.=1.40)和恐惧(M.T.=1.14)。与男性相比,女性表现出更高的压力和恐惧水平(p= 0.001),而专门照顾Covid-19患者的卫生专业人员的压力水平更高(p=0.039)。此外,工作年限≥10年的被调查者比工作年限≤10年的被调查者表现出更高的恐惧(p=0.014)和压力(p=0.044)水平。结论:在大流行期间,信息、个人防护装备的可得性和保护措施的遵守是对医护人员的效率以及恐惧和压力水平产生决定性影响的一些重要因素。
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引用次数: 0
The anxiety of pregnant women with established type 1 or type 2 Diabetes Mellitus – Systematic review 1型或2型糖尿病孕妇的焦虑-系统回顾
Pub Date : 2023-04-01 DOI: 10.24283/hjns.202324
Amalia Karanasou, Eleni Evagelou, Nikoleta Margari, Georgia Kimouliati, Evgenia Vlachou
Introduction: Women with pre-existing type I and II diabetes mellitus in pregnancy are a high-risk group for developing complications in both themselves and their infants. The level of stress women with pre-existing diabetes experience at the early and late pregnancy, may determine its outcome. Aim: The aim of this study was to systematically review the literature regarding the investigation of the anxiety level of pregnant women with pre-existing type I or II D.M. Methodology: A systematic review of the literature was undertaken by searching scientific articles in the Pubmed database. Seven primary studies were included in the present thesis that were written in English, published in the last ten years and included women with pre-existing D.M. Results: The prevalence of anxiety symptoms in pregnant women with D.M. was found to be 40% at the beginning of pregnancy, which is five times higher than in pregnant women without D.M. Pregnancy-related stress was associated with vaginal bleeding, preterm birth, induction of labor and use of birth control medications. A greater improvement in the score of the concise mental element was observed with lower HbA1c in late pregnancy. Conclusions: The prevalence of stress in early pregnancy is higher in women with diabetes and hyperglycemia compared to pregnant women without D.M., but the frequency of stress is not affected by their glycemic status.
妊娠期已有I型和II型糖尿病的妇女是自身及其婴儿发生并发症的高危人群。患有糖尿病的妇女在妊娠早期和晚期的压力水平可能决定其结果。目的:本研究的目的是系统地回顾有关已存在I型或II型糖尿病孕妇焦虑水平调查的文献。方法:通过检索Pubmed数据库中的科学文章对文献进行系统的回顾。本论文纳入了在过去十年中以英文撰写并发表的七项主要研究,其中包括先前患有D.M.的妇女。结果:发现患有D.M.的孕妇在怀孕初期出现焦虑症状的比例为40%,比没有D.M.的孕妇高5倍。与妊娠相关的压力与阴道出血、早产、引产和使用节育药物有关。妊娠后期HbA1c较低的患者,简明心理要素评分有较大改善。结论:与无糖尿病的孕妇相比,有糖尿病和高血糖的孕妇妊娠早期的应激发生率更高,但应激频率不受血糖状态的影响。
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引用次数: 0
Factors affecting the outcome of weaning from mechanical ventilation in patients with tracheostomy in the Intensive Care Unit 影响重症监护室气管切开术患者机械通气脱机结果的因素
Pub Date : 2023-04-01 DOI: 10.24283/hjns.202322
Eftychia Ximeraki, Athina Patelarou, Ilias Samiotis, Charalambos Markakis, Michail Zografakis Sfakianakis
Introduction: Although most patients are easily released from mechanical ventilation, however almost 10% need prolonged mechanical ventilation and undergo a tracheostomy. Aim: Aim of this study was to investigate the factors that may influence the weaning process in tracheostomy patients in the ICU. Methodology: A retrospective cohort study was conducted. Data were collected from the records of 85 adult patients who underwent tracheostomy during their hospitalization in the ICU of a General Regional Hospital, from 2016-2020. For the data collection, a demographic, clinical data recording form and the mechanical ventilation evaluation scale (VIS) were used, recording the 1st, 5th and 10th day after the tracheostomy. The analysis of the study data was done using the SPSS program (IBMCorp. 2019, IBM SPSS Statistics for Windows, v.26.0, Armonk). Results: The total percentage of patients who were successfully weaned was 40%. Patients with successful weaning had significantly lower: Charlson Comorbidity Index score (3.7 vs. 5.0) and higher score on the sum of positive cultures (0-3) (p=0.043). Patients with successful weaning were found to have significantly higher levels of VIS index the 5th (66.6 vs. 33.0) and 10th day (79.8 vs. 34.7). Also, they were positively correlated with the score in the sum of positive cultures (0-3) and with a lower score of VIS 5th (rho = -0.337, p = 0.002) and 10th day (rho = -0.2295, p = 0.012). Finally, through Cox regression, prognostic factors for weaning outcome, multiple diseases (comorbidity) and the duration of mechanical ventilation were assessed. Conclusions: Factors affecting the outcome of weaning were identified. In addition, the value of the VIS prognostic model in the ICU of a General Regional Hospital was confirmed.
虽然大多数患者很容易脱离机械通气,但近10%的患者需要延长机械通气时间并进行气管切开术。目的:本研究旨在探讨影响ICU气管切开术患者脱机过程的因素。方法:采用回顾性队列研究。数据收集自2016-2020年在某综合地区医院ICU住院期间接受气管切开术的85名成年患者的记录。数据收集采用人口统计学、临床资料记录表和机械通气评定量表(VIS),分别记录气管造口术后第1、5、10天的情况。研究数据的分析使用SPSS程序(IBMCorp.)。2019年,IBM SPSS Statistics for Windows, v.26.0, Armonk)。结果:患者成功断奶的总比例为40%。成功脱机患者的Charlson共病指数评分(3.7 vs. 5.0)显著降低,阳性培养总和得分(0-3)显著提高(p=0.043)。成功断奶的患者在第5天(66.6 vs. 33.0)和第10天(79.8 vs. 34.7) VIS指数水平显著提高。与阳性培养数(0-3)和第5天(rho = -0.337, p = 0.002)和第10天(rho = -0.2295, p = 0.012)得分呈正相关。最后,通过Cox回归,评估脱机结局、多种疾病(合并症)和机械通气持续时间的预后因素。结论:确定了影响断奶结局的因素。此外,还证实了VIS预后模型在某综合地区医院ICU中的应用价值。
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引用次数: 0
Pressure ulcers in critically ill: correlation with Intensive Care conditions 危重病人压疮:与重症监护条件的相关性
Pub Date : 2023-04-01 DOI: 10.24283/hjns.202323
Christothea Zervoudaki, Angeliki Konstantinidi, Christina Loukaki, Marina Tzini, Ioanna Velegraki, Maria Koretsi, Ioanna Papoutsaki
Introduction: Critically ill are a special category of patients in need of high standards medical and nursing care. Multiple intrinsic and extrinsic factors that characterize these patients tend to contribute into the development of pressure ulcers. Despite the fact that the implementation of preventive measures seems to inhibit the development of pressure ulcers in a significant percentage, there are often conditions that cannot be surpassed and result to the appearance of unavoidable pressure ulcers. Aim: Study of the factors that contribute to the development of pressure ulcers for the critically ill and the effectiveness of the preventive measures applied in ICU. Method: Information regarding hospitalization data was obtained for all 351 critically ill admitted in an ICU of a regional university hospital during a one year period (May 2021-April 2022). Subsequently, a statistical analysis was performed in order to relate the development of pressure ulcers and intrinsic factors as well as other factors such as medication administered, feeding and preventive measures applied. Results: Incidence of decubitus ulcers was estimated at 23%, first noticed on the 10th day from admission, located in the coccyx at a rate above 50%. Extrinsic factors that seem to contribute to the development of pressure ulcers appear to be the length of ICU stay, the administration of vasoactive drugs and the insufficient caloric and protein coverage through feeding. Use of preventive surfaces, seem to act as a deterrent for pressure ulcer development for the majority of the patients. Most of the pressure ulcers developed during ICU stay, were evaluated as stable or improved during ICU discharge. Conclusions: Improvement of the parameters involved in pressure ulcer development for the critically ill, contribute to the reduction of their occurrence in ICU. Despite the use of advanced pressure reducing surfaces, tissue ischemia may occur even after mild pressure applied. However, high percentage of pressure ulcers could be prevented with appropriate medical care.
危重病人是一类需要高标准医疗护理的特殊病人。这些患者的多重内在和外在因素往往会导致压疮的发展。尽管预防措施的实施似乎在很大程度上抑制了压疮的发展,但往往存在无法超越的条件,导致不可避免的压疮的出现。目的:探讨重症病人压疮发生的相关因素及预防措施的效果。方法:收集某地区大学附属医院ICU一年内(2021年5月- 2022年4月)351例危重患者的住院资料。随后,进行统计分析,以便将压疮的发展与内在因素以及其他因素(如药物管理,喂养和预防措施)联系起来。结果:褥疮的发生率估计为23%,首次发现于入院后第10天,位于尾骨,发生率超过50%。导致压疮发生的外部因素似乎包括ICU的住院时间、血管活性药物的使用以及喂养中热量和蛋白质覆盖的不足。使用预防性表面,似乎对大多数患者的压疮发展起到了威慑作用。大多数压疮是在ICU住院期间发生的,出院时评估为稳定或改善。结论:ICU危重病人压疮发展相关参数的改善有助于降低压疮的发生率。尽管使用了先进的减压表面,组织缺血可能发生后,即使轻微的压力施加。然而,通过适当的医疗护理可以预防很大比例的压疮。
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引用次数: 0
The role of psychoeducation in psychological trauma 心理教育在心理创伤中的作用
Pub Date : 2023-04-01 DOI: 10.24283/hjns.202326
Polyxeni Mangoulia
The experience of traumatic event may lead to short-term and long-term health problems. There are different therapeutic interventions for psychological trauma, psychoeducation is one of them. Psychoeducation for trauma therapy is an evidenced based psychotherapeutic intervention including information about the health problem, skills training, and support. The purpose of the study was to investigate the application of psychoeducation for the treatment of psychological trauma. A review of the scientific literature in the PubMed and Google Scholar databases was performed. There are mixed results in studies and clinical practice regarding psychoeducation in trauma therapy, therefore most of them are very satisfying and encouraging. Psychoeducation can be delivered at different time points, before a potentially traumatic event or after the event, encouraging help seeking, reducing stigma, and reinforcing mental resilience and prosperity of people. Applying psychoeducation right after the traumatic experience, doesn’t seem to be very effective but it’s important to start as soon as possible and often, take into consider the individual characteristics and culture. Certainly, more studies are needed to investigate all dimensions of this intervention.
创伤性事件的经历可能导致短期和长期的健康问题。心理创伤的治疗手段多种多样,心理教育是其中之一。创伤治疗的心理教育是一种基于证据的心理治疗干预,包括有关健康问题的信息,技能培训和支持。本研究旨在探讨心理教育在心理创伤治疗中的应用。对PubMed和Google Scholar数据库中的科学文献进行了回顾。心理教育在创伤治疗中的研究和临床实践结果喜忧参半,但大多数都是令人满意和鼓舞的。心理教育可以在不同的时间点进行,在潜在的创伤事件发生之前或事件发生之后,鼓励寻求帮助,减少耻辱感,增强人们的心理弹性和繁荣。在创伤经历之后立即进行心理教育,似乎不是很有效,但尽早开始是很重要的,而且要考虑到个人的特点和文化。当然,需要更多的研究来调查这种干预的所有方面。
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引用次数: 0
Exploring the role of school nurses in primary schools: a literature review 探讨学校护士在小学的角色:文献回顾
Pub Date : 2023-04-01 DOI: 10.24283/hjns.202325
Sofia Lykopoulou, Ourania Georgia Mitsi, Elpiniki Laiou
Introduction: The school nurse promotes the health of students within their sphere of responsibility, protects their safety and aims at their balanced development. They therefore have the potential to directly contribute to the assessment, early management and prevention of health problems in the school environment. Aim: The aim of this bibliographic review was to investigate contemporary research articles on the role of school nurses in prevention, health problem management and health promotion in primary schools. Methodology: Scientific literature searches were conducted in the electronic databases PubMed andScopus using the keywords: “primary school” and “school nurse”. The criteria used for the inclusion of articles in the review were that they should describe research studies related to health interventions in primary schools and the role of school nurses, published within the last decade in English or Greek. The sample of the present work consisted of 13 research articles (2012 - 2019). Results: The research studies reported on the prevention and treatment of obesity, the promotion of hand hygiene and influenza vaccination, the prevention of school bullying and sexual abuse, and the management of type 1 diabetes. Further studies investigated the management of stress and sleep problems, the prevention of nail biting and the management of seizures within the school environment. Conclusions: According to the contemporary scientific literature, the role of school nurses in primary schools is potentially multidimensional. The school nurse can contribute substantially towards promoting the health and balanced development of that particular school population.
导言:学校护士在其职责范围内促进学生的健康,保护他们的安全,并以他们的均衡发展为目标。因此,它们有可能直接促进学校环境中的健康问题的评估、早期管理和预防。目的:本文献回顾的目的是调查当代关于学校护士在小学预防、健康问题管理和健康促进中的作用的研究文章。方法:以“primary school”和“school nurse”为关键词在PubMed和scopus电子数据库中进行科学文献检索。文章纳入审查的标准是,它们应描述与小学卫生干预措施和学校护士的作用有关的研究,并在过去十年内以英语或希腊语发表。本研究的样本包括13篇研究论文(2012 - 2019)。结果:研究报告了肥胖的预防和治疗、促进手卫生和流感疫苗接种、预防校园欺凌和性虐待以及1型糖尿病的管理。进一步的研究调查了压力和睡眠问题的管理、咬指甲的预防和学校环境中癫痫发作的管理。结论:根据当代科学文献,学校护士在小学的作用是潜在的多维的。学校护士可以为促进该特定学校人口的健康和均衡发展作出重大贡献。
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引用次数: 0
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